How much does Medicare pay for CPT 93281?

Medicare allowed an average of $66.91 per service and paid $49.77 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $220.60, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93281?

Programming of multiple lead pacemaker system. It was billed 43,864 times to 32,672 Medicare beneficiaries by 1,428 providers in 2024.

Does 93281 pay differently in an office than a hospital?

Yes. The allowed amount averaged $73.05 in an office setting and $39.11 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 93281 most?

Clinical Cardiac Electrophysiology, with 28,527 services from 876 clinicians. Next are Cardiology, Nurse Practitioner, Physician Assistant.

CPT 93281

Programming of multiple lead pacemaker system

$66.91Medicare-allowed amount per service, averaged across 43,864 services

Providers submitted

$220.60

Asking price, not received

Medicare allowed

$66.91

The fee schedule figure

Medicare paid

$49.77

Balance is patient coinsurance

Providers submitted an average of $220.60 for this code and Medicare allowed $66.91 — 3.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $49.77 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $73.05
Hospital / facility: $39.11

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 35,931 services were billed in an office setting and 7,933 in a facility.

Services: 43,864
Beneficiaries: 32,672
Providers billing it: 1,428
Total allowed: $2,934,940

What Medicare pays for CPT 93281

Across 43,864 services billed by 1,428 providers to 32,672 beneficiaries, Medicare allowed an average of $66.91 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 93281

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Cardiac Electrophysiology	28,527	21,056	$67.92	876
Cardiology	8,711	6,460	$68.52	314
Nurse Practitioner	3,364	2,672	$56.35	125
Physician Assistant	1,285	981	$59.66	35
Interventional Cardiology	919	685	$68.43	36
Internal Medicine	794	615	$67.11	29
Hospitalist	72	58	$70.85	4
Cardiac Surgery	52	40	$53.60	3
Advanced Heart Failure and Transplant Cardiology	44	26	$76.83	2
Critical Care (Intensivists)	41	31	$76.96	1
Undefined Physician type	22	21	$77.49	1
Family Practice	21	16	$77.92	1
Certified Clinical Nurse Specialist	12	11	$33.67	1

93281 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	3,763	$64.66	$48.24	102
Florida	2,725	$74.21	$55.69	85
Illinois	2,623	$75.56	$54.43	71
California	2,312	$77.26	$51.77	82
North Carolina	2,242	$63.68	$49.88	68
Virginia	2,193	$54.21	$39.12	68
New York	2,150	$78.24	$52.35	72
Arizona	1,906	$74.68	$57.36	53
Georgia	1,834	$67.05	$50.63	57
Ohio	1,597	$65.72	$50.41	62
South Carolina	1,531	$65.93	$51.28	47
Pennsylvania	1,385	$69.38	$50.96	63
Tennessee	1,144	$62.53	$48.97	42
New Jersey	1,125	$81.06	$53.68	36
Indiana	1,028	$68.59	$52.50	34
Minnesota	1,017	$64.62	$44.81	41
Montana	882	$66.42	$48.51	10
Michigan	873	$51.77	$37.92	33
Washington	859	$65.70	$45.99	28
Maryland	803	$79.50	$53.50	24
Mississippi	775	$58.84	$43.88	21
Missouri	774	$67.35	$52.01	33
Kansas	594	$66.68	$52.39	15
Kentucky	565	$63.51	$50.79	18
Arkansas	552	$45.50	$34.64	20
Wisconsin	550	$63.21	$47.99	23
Alaska	550	$79.37	$46.30	6
Massachusetts	509	$61.95	$43.12	23
Iowa	492	$41.42	$31.60	18
Alabama	464	$53.83	$41.02	20
Nevada	451	$71.27	$52.02	14
Oklahoma	373	$50.48	$39.47	10
Connecticut	358	$65.69	$43.88	16
Nebraska	354	$63.77	$52.09	12
Louisiana	245	$64.83	$50.09	7
West Virginia	230	$53.70	$41.87	10
Colorado	230	$76.93	$53.90	10
Utah	201	$69.13	$53.97	7
North Dakota	191	$41.47	$29.42	7
Oregon	172	$65.98	$47.18	8
District of Columbia	165	$82.22	$55.39	6
Maine	165	$43.53	$30.26	8
Hawaii	155	$46.46	$33.16	6
New Mexico	140	$38.67	$24.63	6
Idaho	132	$40.12	$31.23	4
New Hampshire	120	$44.67	$33.03	5
South Dakota	104	$38.91	$28.31	4
Rhode Island	96	$53.33	$34.54	5
Vermont	86	$49.36	$36.40	5
Delaware	79	$65.10	$47.14	3

Related codes

93296Evaluation of single$21.59
93294Evaluation of single$28.57
93298Evaluation of cardiac rhythm monitor system$76.45
93297Evaluation of implantable heart and blood vessel monitoring system$45.47
93280Programming of dual lead pacemaker system$61.84
93295Evaluation of single$35.37
93229Electrocardiogram (ecg) up to 30 days continuous$1018.21
93247Heart rhythm analysis and report of continous external ekg over 8-15 d$299.31
93248Heart rhythm review and interpretation of continous external ekg over$24.98
93228Electrocardiogram (ecg) up to 30 days continuous$24.32
93243Heart rhythm analysis and report of continous external ekg over more t$279.98
93244Heart rhythm review$22.39

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.